Building a national evidence base on diet, nutrition and oral health across the life course

This work contributed to an international competency framework for diet and nutrition in oral health education, developed through the ADEE Community of Practice on Nutrition. Key outputs include:

• A validated food science and nutrition module embedded in the BDentSc curriculum
• Digital diet history tools adapted for dental clinical settings
• A global survey of nutrition education practices in dental schools
• Co-authorship of a framework for diet and nutrition competencies in oral health care

The Division II study examined athletes across Olympic sports, combining clinical oral health examination with detailed dietary assessment. Key findings:

• High caries prevalence despite awareness of sugar risk
• Frequent use of sports nutrition products contributing to cariogenic acid exposure
• Fluoride intake below recommended levels in a significant proportion of athletes
• Ongoing work: pre-competition oral health screening protocol and a practical guide for sports nutrition staff

This study raises the question of whether the oral cavity is an unrecognised reservoir for catheter-related bloodstream infections in this vulnerable patient group. Key findings and next steps:

• 72% of patients had untreated dental caries; 17% had oral MRSA colonisation
• Oral health needs are largely unmet in this population due to systemic illness complexity
• Two further papers in preparation examining infection pathways and clinical recommendations
• Collaboration with the national intestinal failure and home parenteral nutrition service at St James's Hospital

TCD/DDUH's role within the SWEETWISE consortium focuses on the oral health impact of infant foods and the development of a novel in vitro model:

• Systematic mapping of free sugar content in commercially available infant complementary foods in Ireland
• Development of an in vitro cariogenicity model to test reformulated products
• Assessment of feeding practices and sugar exposure in 3-year-olds from Growing Up in Ireland
• Translation of findings into reformulation targets and public health messaging for parents

Using individual-level geocoded lifetime fluoride exposure estimates linked to national cohort data, this programme provides the most comprehensive Irish evidence on fluoride, oral health and cognition to date:

• No association between lifetime CWF exposure and cognitive function in older adults (IRR = 1.00, fully adjusted)
• 52-year longitudinal analysis of fluoride levels across Irish water supply zones
• Socioeconomic patterning of oral health in Irish adolescents (GUI '98)
• Grant: HRB SDAP-2025-017 — €349,926 — commenced December 2025

Applying life-course epidemiological methods across GUI Cohorts '98, '08 and '24, this PhD programme identifies critical periods for prevention and the social determinants of oral health inequality in children and young people:

• Trajectories of dental caries and oral hygiene behaviours from infancy to young adulthood
• Role of diet, fluoride exposure and socioeconomic factors in shaping oral health outcomes
• Linkage across GUI cohort waves to examine intra- and inter-generational patterns
• PhD candidate: Sudipta Saha, TCD (commenced September 2026)
• Co-PI: Prof Michael O'Sullivan, DDUH/TCD